This edition we talked to Amy, SHINE SA’s Medical Educator, who is answering all your questions when it comes to the ‘what’s this’ and ‘how do I check that’ of sex.
SHINE SA offers services for relationships and sexual health (including STIs and contraception), as well as being a safe and inclusive space for all genders and sexualities. www.shinesa.org.au
How often should people who are sexually active get tested?
You should have a test when symptoms of a Sexually Transmitted Infection (STI) are first noticed or if a sexual partner is diagnosed with an STI or has symptoms of an STI. Even if you have no symptoms STI screening is recommended for any new sexual contact. Annual screening for people under 30 is recommended, but you can have a test every 3 months if you think you may be at higher risk.
Will your GP test you, or is there a different doctor to go to?
Your GP should be able to give you an STI test, however not all GPs are as experienced or comfortable with STIs as others. If you don’t have a regular GP, or are not comfortable asking your GP about STIs, you can access specialised sexual health services at SHINE SA or Clinic 275.
If you really don’t want to see someone, you can get a free online chlamydia test at the Get Checked Now website if you are under 30 and have medicare.
What should I be tested for?
All sexually active people under the age of 30 should have a test for chlamydia and hepatitis B. You could also consider a HIV and syphilis test. This can depend on your chance of exposure to these STIs and your doctor may ask some questions to assess this. Men who have sex with men should have an annual test for chlamydia, gonorrhoea, HIV and syphilis. Also a check for hepatitis A and B status and vaccination if not immune. People from Aboriginal and Torres Strait Islander backgrounds also have specific testing guidelines.
What is the most common STI/STD and why is this? Are STIs in general common?
Chlamydia is the most common STI. There have already been 3742 cases in SA this year and the number of cases each year are rising. There are lots of reasons for this. Chlamydia is easily transmitted through sexual fluids, often has no symptoms and can stay in the body for months.
Some STIs are more common than others. Chlamydia is 2-3 time higher in SA than the common causes of food poisoning or gastro.
Will I know if I have an STI?
Most STIs are undetectable, particularly in the early stages. Up to 70% of people with chlamydia have no symptoms. By the time it does cause symptoms you may have already passed it on or have developed long term consequences such as chronic pelvic pain or infertility.
If you do have symptoms they can be pain when urinating, discharge from the vagina or penis, pain in the lower abdomen, pain or bleeding during or after sex or between periods. Some STIs can also infect the anus after anal sex and cause pain.
How can you catch HIV?
You don’t really ‘catch’ HIV. HIV is a virus that is transmitted in 3 main ways.
- Blood to blood contact (e.g. sharing injecting, tattooing or piercing equipment)
- Sexual contact (e.g. unprotected anal or vaginal intercourse)
- Mother to child (during pregnancy, childbirth or breastfeeding)
HIV can NOT be transmitted via other body fluids such as saliva, urine, sweat, etc. nor can it be transmitted by other types of casual contact (such as kissing, sharing cups, cutlery, toilet seats, etc).
Why is the rate of HIV rising again lately?
HIV numbers across Australia aren’t rising, they’re remaining stubbornly stable. However, with the introduction of Pre Exposure Prophylaxis (PrEP) in SA we expect to see a decline as has occurred in U.K. and USA.
Can you get an STI from Oral sex? Why?
You can get an STI from receptive oral sex. Gonorrhoea in particular, likes to live in the throat and this can then be passed back to the genitals. This usually has no symptoms so MSM are recommended to have a throat swab as part of their routine check up. Chlamydia in the throat is rare. Genital herpes can also possibly be transmitted through oral sex, for example if the giver has a ‘cold sore’.
Human papilloma virus (HPV) is transmitted through any form of sexual contact including oral sex. Some types of HPV can increase the risk of cervical cancer, mouth and throat cancers, and anal cancer. It’s important to make sure you have been fully vaccinated. People with a cervix should follow the recommended guidelines for cervical screening if they have ever had any form of sexual contact.
When you give blood there’s an option that asks if you’re a woman who has had sex with a man who may have had sex with another man. Why is that?
HIV does not discriminate. Anyone who is exposed to HIV can get it. There are, however, groups of people who are more commonly diagnosed with HIV in Australia. Gay men and MSM and people from high prevalence countries (mostly heterosexual) are the key affected populations in South Australia.
Some MSM also have female partners and a woman may acquire HIV from a man who has sex with other men, if that person has HIV. People who are practising safer sex and are aware of their own and their partner’s risk have a lower risk of any STI.
For same sex couples, how do you practice ‘safe sex’?
All people in a new relationship should have an STI check before starting to have unprotected sex. People with a penis should use a condom before insertive anal, vaginal and oral sex if there is a risk of STI.
For same sex attracted women it’s important to be aware STIs can be passed on through skin to skin contact such as genital to genital, but also finger/hand to genital. Using a dental dam during oral sex can reduce your chance of getting an STI, also using a condom with dildos and properly washing all shared sex toys.
Keeping nails trim can reduce the risk of trauma to the vagina, which reduces your chance of blood borne viruses (BBVs) like HIV, hepatitis and syphilis. The chance of transmission of a BBV is highest during a menstrual period.
What is PrEP? Is it relevant to people in a monogamous relationship?
PrEP is a tablet taken every day which reduces the transmission of HIV. It is highly effective and means that couples where one partner is HIV positive can have sex without a condom and not worry about their partner acquiring HIV. It is also useful for people having higher risk sex who are not in a relationship, but still don’t use a condom. For more information on accessing PrEP in SA go to http://www.samesh.org.au/prep.html
What’s ‘normal’ down there?
Penises come in all shapes and sizes, look different when circumcised and also when erect. Vulvas also come in a variety and generally look nothing like the airbrushed versions seen in porn. If you are worried yours isn’t ‘normal’, visit the Labia Library online. Get to know your genitals, don’t be afraid of them, and if anything changes see a doctor or nurse.
For more information go to the SHINE SA website at www.shinesa.org.au
Words conducted by Amy Moten.
Images by Rachael Sharman.